Research: RAMARATNAM and SRIDHAR

Listed in Issue 64

Abstract

RAMARATNAM and SRIDHARAN, Department of Neurology, Apollo Hospitals, 21 Greams Lane, off Greams Road, Madras, Tamil Nadu, India, 600006, rsridharan@vsnl.com assessed the efficacy of yoga in the treatment of patients with epilepsy.

Background

Stress is thought to be an important factor in precipitating seizures. Yoga can induce relaxation and reduce stress; effects on the electroencephalogram (EEG) and autonomic nervous system have been reported. If effective in epilepsy, it would be an attractive therapeutic option.

Methodology

Reports of controlled trials (search criteria: randomized control trials and controlled clinical trials) of the treatment of epilepsy with yoga were obtained by searching the following: the Cochrane Epilepsy Group trial register; the Cochrane Controlled Trials Register (The Cochrane Library Issue 4, 1998); MEDLINE for articles published up to the middle of 1998; and registries of the research council for complementary medicine. References of all the identified studies were also searched. Members of the Neurological Society of India, several neurophysiology institutions and yoga institutes were also contacted to find information about any ongoing studies or studies published in nonindexed journals or unpublished studies. The two reviewers extracted the data independently. Any discrepancies were resolved by discussion. The main outcomes assessed were: percentage of patients rendered seizure free; number of patients with more than 50% reduction in seizure frequency or duration; and overall reduction in seizure frequency. Analyses were on an intention-to-treat basis.

Results

Only one study met the selection criteria. 32 patients were recruited: 10 to sahaja yoga, 22 to control treatments. All patients continued with anti-epileptic medication. Randomisation was by roll of a dice. 4 patients treated with yoga were seizure free for 6 months compared with none in the control groups. The odds ratio (OR) for yoga treatment versus sham yoga was 14.5 and for yoga versus no treatment was 17.3. 9 patients treated with yoga had more than 50% reduction in seizure frequency compared with only one among the controls. The OR for yoga versus sham yoga was 81 and for yoga versus no treatment was 158.3. Yoga-treated patients had a decrease in the average number of attacks per month compared to baseline. The weighted mean difference between yoga versus sham yoga was –2.1 and between yoga versus no treatment was –1.1. 7 of the 10 patients treated with yoga had a more than 50% reduction in seizure duration, compared with none among the 22 controls. The OR for yoga versus sham yoga was 45 and for yoga versus no treatment was 53.57.

Conclusion

No reliable conclusions could be drawn regarding the efficacy of yoga as a treatment for epilepsy. Further studies are needed.

References

Ramaratnam S, Sridharan K. Yoga for epilepsy. The Cochrane Database of Systematic Reviews (2): CD001524. 2000.

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